INTRODUCTION: Despite promising trials, catheter ablation is still regarded as an adjunct to antiarrhythmic drugs (AADs) in the treatment of paroxysmal atrial fibrillation (PAF). This study aimed to compare the effectiveness of various ablation therapies and AADs. METHOD: Randomised controlled trials or propensity score-matched studies comparing atrial tachyarrhythmia recurrence among any combination of ablation modalities or AAD were retrieved. Kaplan-Meier curves and risk tables for this outcome were graphically reconstructed to extract patient-level data. Frequentist network meta-analysis (NMA) using derived hazard ratios (HRs), as well as 2 restricted mean survival time (RMST) NMAs, were conducted. Treatment strategies were ranked using P-scores. RESULTS: Across 24 studies comparing 6 ablation therapies (5,132 patients), Frequentist NMA-derived HRs of atrial fibrillation recurrence compared to AAD were 0.35 (95% confidence interval [CI]=0.25-0.48) for cryoballoon ablation (CBA), 0.34 (95% CI=0.25-0.47) for radiofrequency ablation (RFA), 0.14 (95% CI=0.07-0.30) for combined CBA and RFA, 0.20 (95% CI=0.10-0.41) for hot-balloon ablation, 0.43 (95% CI=0.15-1.26) for laser-balloon ablation (LBA), and 0.33 (95% CI=0.18-0.62) for pulmonary vein ablation catheter. RMST-based NMAs similarly showed significant benefit of all ablation therapies over AAD. The combination of CBA + RFA showed promising long-term superiority over CBA and RFA, while LBA showed favourable short-term efficacy. CONCLUSION The advantage of ablation therapies over AAD in preventing atrial tachyarrhythmia recurrence suggests that ablation should be considered as the first-line treatment for PAF in patients fit for the procedure. The promising nature of several specific therapies warrants further trials to elicit their long-term efficacy and perform a cost-benefit analysis.
Humans ; Anti-Arrhythmia Agents/therapeutic use* ; Atrial Fibrillation/surgery* ; Catheter Ablation/methods* ; Heart Atria ; Network Meta-Analysis ; Recurrence ; Treatment Outcome ; Randomized Controlled Trials as Topic

Objective To study the affect of psychological intervention to anxiety-depression emotion and T Lvmlcih cells in breast cancer patients during the peri-operation. Methods We divided 60 cases into two groups at random. the experiment group(30) and the control group(30).The psychological situation Was evaluated according to the scores of Self-Rating Anxiety Status Inventory(SAS)and Depression Status Inventory (SDS).2 ml of venous blood Was taken to measure the level of T lymph cells. Then the experiment group Was given the specific and generalized psychological interventions. while the control group was given only the common nursing care. Results The scores of anxiety(8.65±3.69)and depression(31.70±5.79)after the intervention in the experiment group were lower than those before the intervention。and had significant difference (P<0.05).After the operation，the average value of CD3，CD4，CD4／CD8 in the experiment group was higber than that of the control group，and the values of CD3 and CD4 had statistical meaning(P<0.05).After the intervention，the vatues of CD3,CD4，CD4／CD8 of the experiment group were higher than those before the intervention. and the values of CD3 and CD4 had obvious difference(P<0.05).Conclusions In this study, a suitable and effective psychological intervention can improve the status of anxiety and depression of patients with breast cancer during the peri-operative period, and at the same time can modulate the immune status.

Objective To identify the levels of exposure to second-hand smoking (SHS)among Chinese adults living in the urban areas and their knowledge on the risks of SHS,to support for the Smoke-free policy.Methods Data from the Global Adult Tobacco Survey (GATS) and the International Tobacco Control Policy Evaluation China Survey (ITC China Survey) was analyzed and SAS was used to calculate the rates and 95％ CI.Results In the two surveys,less than 40％ of the respondents reported that their workplaces had completely stopped smoking.Participants who reported that they had seen people smoking at various public places with different rates,also they could reflect the levels to SHS exposure.Restaurants were the venue with the heaviest overall exposure (83.4％-95.6％),followed by the workplace (53.3％-84.0％).Exposure was low in health facilities,schools and public transport venues.In the GATS survey,60.6％ smokers and 68.5％ non-smokers believed that SHS could cause lung cancer,but only one-third of the participants believed that SHS could cause heart diseases in adults.Participants in the ITC China survey reported a comparatively higher level of awareness on the harm of SHS,but only 58.2％ smokers believed that SHS could cause heart diseases in adults.Overall,data from the ITC China survey showed that participants' support for a comprehensive smoke-free policy in schools,health-related facilities,government buildings and in taxi were high (over 70％).However,the proportion of participants supporting comprehensive smoking-free policy at workplaces (50.9％-60.9％) was relatively low.Conclusion The proportion of indoor workplaces with complete smoking ban was low in urban areas but levels to SHS exposure were high.People's awareness of harms related to SHS and their attitude on setting up a comprehensive smoke-free workplace need to be improved.

Objective To find a suitable cell line for hepatitis A antigen expressed by vaccinia virus vector and to find a way of inactivation and preservation of the HAV recombinant antigen.Methods Series of cell lines such as K4,143,HEL,Hep-2 and Vero were inoculated with vaccinia virus that can express HAV recombinant antigen.ELISA was used to determine the contents of expression antigen.The chracteration of the HAV antigen expressed by vaccinia virus was then analyzed after it was treated with different methods.Results The expression of HAV recombinant antigen in K4,143 and HEL cell lines was a little more than expression in Hep-2 and Vero cell lines.The antigenicity is obviously higher when HAV recombinant antigen was inactivated by β-propiolactone other than it was inactivated by formalin.It was best to preserve the prepared HAV recombinant antigen under -40℃ condition.Conclusions The application of vaccinia virus vector in hepatitis A antigen preparation was very useful and promising.